TY - JOUR
T1 - Alcohol use and tuberculosis clinical presentation at the time of diagnosis in Puducherry and Tamil Nadu, India
AU - Kan, Carolyn K.
AU - Ragan, Elizabeth J.
AU - Sarkar, Sonali
AU - Knudsen, Selby
AU - Forsyth, Megan
AU - Muthuraj, Muthaiah
AU - Vinod, Kumar
AU - Jenkins, Helen E.
AU - Horsburgh, C. Robert
AU - Salgame, Padmini
AU - Roy, Gautam
AU - Ellner, Jerrold J.
AU - Jacobson, Karen R.
AU - Sahu, Swaroop
AU - Hochberg, Natasha S.
N1 - Funding Information:
This project has been funded by Award No. USB-31150-XX-13 of the US Civilian Research & Development Foundation (CRDF Global) and by the National Science Foundation under Cooperative Agreement No. OISE-9531011 with Federal funds from the Government of India's (GOI) Department of Biotechnology (DBT), the Indian Council of Medical Research (ICMR), the United States National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID), Office of AIDS Research (OAR), and distributed in part by CRDF Global to SS, JE, PS, GR, CRH, and NSH. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the DBT, the ICMR, the NIH, or CRDF Global. NSH is also supported in part by a grant from the Warren Alpert Foundation and Boston University School of Medicine.
Publisher Copyright:
© 2020 Kan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/12
Y1 - 2020/12
N2 - Setting Alcohol use increases the risk of tuberculosis (TB) disease and is associated with worse outcomes. Objective To determine whether alcohol use affects TB severity at diagnosis in a high-burden setting. Design Participants were smear-positive people living with TB (PLWTB) in India. Disease severity was assessed as 1) high versus low smear grade, 2) time to positivity (TTP) on liquid culture, 3) chest radiograph cavitation, and 4) percent lung affected. Alcohol use and being at-risk for alcohol use disorders (AUD) were assessed using the AUDIT-C. Univariable and multivariable analyses were conducted. Results Of 1166 PLWTB, 691 (59.3%) were drinkers; of those, 518/691 (75.0%) were at-risk for AUD. Drinkers had more lung affected than non-drinkers (adjusted mean difference 10.8%, p<0.0001); this was not significant for those at-risk for AUD (adjusted mean difference 3.7%, p = 0.11). High smear grade (aOR 1.0, 95%CI: 0.7-1.4), cavitation (aOR 0.8, 95%CI 0.4-1.8), and TTP (mean difference 5.2 hours, p = 0.51) did not differ between drinkers and non-drinkers, nor between those at-risk and not at-risk for AUD. Conclusions A large proportion of PLWTB were drinkers and were at-risk for AUD. Alcohol drinkers had more lung affected than non-drinkers. Studies are needed to explore mechanisms of this association.
AB - Setting Alcohol use increases the risk of tuberculosis (TB) disease and is associated with worse outcomes. Objective To determine whether alcohol use affects TB severity at diagnosis in a high-burden setting. Design Participants were smear-positive people living with TB (PLWTB) in India. Disease severity was assessed as 1) high versus low smear grade, 2) time to positivity (TTP) on liquid culture, 3) chest radiograph cavitation, and 4) percent lung affected. Alcohol use and being at-risk for alcohol use disorders (AUD) were assessed using the AUDIT-C. Univariable and multivariable analyses were conducted. Results Of 1166 PLWTB, 691 (59.3%) were drinkers; of those, 518/691 (75.0%) were at-risk for AUD. Drinkers had more lung affected than non-drinkers (adjusted mean difference 10.8%, p<0.0001); this was not significant for those at-risk for AUD (adjusted mean difference 3.7%, p = 0.11). High smear grade (aOR 1.0, 95%CI: 0.7-1.4), cavitation (aOR 0.8, 95%CI 0.4-1.8), and TTP (mean difference 5.2 hours, p = 0.51) did not differ between drinkers and non-drinkers, nor between those at-risk and not at-risk for AUD. Conclusions A large proportion of PLWTB were drinkers and were at-risk for AUD. Alcohol drinkers had more lung affected than non-drinkers. Studies are needed to explore mechanisms of this association.
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U2 - 10.1371/journal.pone.0240595
DO - 10.1371/journal.pone.0240595
M3 - Article
C2 - 33332367
AN - SCOPUS:85098270147
SN - 1932-6203
VL - 15
JO - PloS one
JF - PloS one
IS - 12 December
M1 - e0240595
ER -